Provider Demographics
NPI:1265214837
Name:ABA KIDS CONNECTION INC
Entity type:Organization
Organization Name:ABA KIDS CONNECTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYVA MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-557-1525
Mailing Address - Street 1:4236 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5241
Mailing Address - Country:US
Mailing Address - Phone:813-557-1525
Mailing Address - Fax:813-435-2015
Practice Address - Street 1:4236 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5241
Practice Address - Country:US
Practice Address - Phone:813-557-1525
Practice Address - Fax:813-435-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center